Alcohol related liver disease

Alcohol related liver disease (ARLD) is when the liver gets damaged due to drinking a lot of alcohol over a long period of time.

The damage caused can lead to scarring (fibrosis), which can lead to cirrhosis and the liver not working properly.

What does the liver do? 

Your liver is the largest organ inside your body and performs hundreds of important jobs. These include:

• Cleaning your blood and getting rid of harmful chemicals (toxins), including alcohol
• Storing minerals, vitamins and glycogen
• Breaking down red blood cells that are over a certain age
• Producing bile, a fluid that helps you digest fat
• Producing blood proteins, including those that make your blood clot which are important for healing wounds

Alcohol related liver disease is caused by someone drinking too much alcohol. The more alcohol you drink, or the more you binge drink, the higher your chances are of developing it.  

Other factors can increase your chances of developing alcohol related liver disease. These include:

• Being overweight or obese
• Having diabetes
• Genetics, as alcohol related liver disease can run in families

Alcohol related liver disease can go undetected for many years. This means you may only show symptoms when alcohol related liver disease is at an advanced stage.

Signs of alcohol related liver disease include:

• Loss of muscle mass
• Weight loss
• Not being able to think clearly (this is called hepatic encephalopathy)
• A swollen belly or legs
• Jaundice, which comes up as yellow coloured skin, yellow eye whites or yellow mucous membranes (inner linings of the nose or mouth)

If your doctor thinks you have alcohol related liver disease, you may have the following tests at The London Clinic to diagnose it:

• Blood tests
• Scans, such as an ultrasound, CT or MRI scan, or a FibroScan
• A liver biopsy, were a fine needle is used to remove a sample of liver cells so they can be examined under a microscope
• Endoscopy

If tests show you have alcohol related liver disease, you may be referred to see a doctor who specialises in liver problems, called a hepatologist.

Chronic alcoholic liver disease can be divided into four main stages:

Stage 1

At stage 1, most heavy drinkers develop a fatty liver because if the liver is damaged it can’t break down fat properly. This stage usually produces no symptoms and gets better if the amount of alcohol a person drinks is reduced.

Stage 2

During stage 2, the liver becomes swollen and painful (inflamed). This is called steatohepatitis. In severe cases, jaundice may develop. A diagnosis of acute alcoholic hepatitis is made at this point.

Stage 3

By stage 3, scar tissue (fibrosis) begins to form in the liver. Again, this cannot be detected by blood tests or routine scans.

Stage 4

At stage 4, advanced fibrosis in the liver becomes cirrhosis. The liver stops looking smooth and purple. Instead, it looks pale grey, with a knobbly appearance that’s been described as toad-like. 

The liver also stops functioning properly in many different ways. Once liver cirrhosis develops, the future outcomes for a person depend heavily on whether they continue to drink alcohol or not.

There are four ways that alcohol related liver disease can be treated:

Stop drinking alcohol

If you’re diagnosed with alcohol related liver disease (ARLD), the key to treating it is reducing how much alcohol you drink and doing this slowly over time. If your ARLD is at an advanced stage, this may mean you need to stop drinking alcohol completely. 

If you stop drinking alcohol or reduce your intake, damage to your liver may be reversed. But if your ARLD is at an advanced stage, such as alcoholic hepatitis or cirrhosis, it’s a lot harder for your liver to fully recover. 

At The London Clinic, we can help you find ways to reduce your intake of alcohol. We can also recommend how you do this and refer you to professionals who specialise in helping people reduce their alcohol intake. 

Diet and nutrition

People who drink too much alcohol may not eat well, so they may not be getting all the nutrients they need. 

At The London Clinic, we have a world-class dietetics and nutrition team who can support your recovery and long-term health by helping you eat and drink better. By improving what you eat on a daily basis, you can support your liver’s recovery.

Monitoring

If you’ve been diagnosed with advanced liver disease, you may be at risk of future problems, such as portal hypertension.

To make sure signs of these problems are spotted early, we offer a range of screening tests. 

Liver transplant

In the most serious cases of ARLD, your liver may lose its ability to function and lead to liver failure. A liver transplant is currently the only way to cure liver failure that cannot be reversed.

If warning signs are spotted during monitoring, our specialists can then take action to prevent an issue developing or becoming worse.